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HomeMy WebLinkAbout19987-z ` FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22510 Date AUGUST 6, 1993 THIS CERTIFIES that the building ADDITION Location of Property 1065 SALTAIR WAY MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section I00 Block 1 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 1991 pursuant to which Building Permit No. 19987-Z dated JUNE 27, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to RORY & JENNIE FORRESTAL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-234178 - MAY 6, 1992 PLUMBERS CERTIFICATION DATED AUGUST 5, 1993 - R. FORRESTAL Building Inspector Rev. 1/81 iOSffi NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 1 9 9 8 7 Z ate ~..~s~~.....~.?.........., 1991... ' Permission is hereby granted to: ~oc~~ s .:~-~.c.~...... ~.:y.,.....4~.9 ..1.~ ,,o' at premises locote at ~9. s~.'..... 4il.4R,...~..:... ........~.:~.41 • rk.....4~!`--.......... County Tox Mop No. 1000 Section 81ock/ d. Lot No..... ' pursuant to application doted ...............~4s4M,R.......~.W..........., 19..g.~.., and approved by the Budding Inslpector. Fee S..l.l~7.!. Bu d Inspector Rev. 6/30/80 v - Form No. 6 TOWN OF SOUTHOLD ~ ~ ~r `t''`` BUILDING DEPARTMENT g TOWN HALL ~ ~ A~1~ W 6 765-1802 -~-,,,.,u..<.. APPLICATION FOR CERTII•ICATE OF OCC~"l1NCY'-'~=~-.-wr':',,: , ' A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept, of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 17, lead. 5. Commercial building, industrial building, multiple residences and similar buildings ~ and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2.. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential//$15q.-00, 7Commercial $15.00 Date ~3 ; . u.://J . New Construction........... Old Or P~r^e-existing Building......u!......... Location of Property... ~Q.~ S .....:-)f~"~!l9JlZ.:..G~~ House No. Street Hamlet . / i _ Onwer or Owners of Property.... hO~c'! , E ~1 E. , ,~{J;r?~!?~°! •~;v C . . . . . . . County Tax Map No 1000, Section....~...Block....,~~.........Lpt...~Z~,,,,,,,,,,,, Subdivision.// ...................................Filed Map............Lot...................... Permit No.. 1. ~ ~ 7~L," „Date Of Permit. 7~~~....Applicant...~%/~/.f~ Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval . Request for: Temporary Certificate........... Final Certicate.........., Fee Submitted: $ APPLICANT' co Baas ro INSPECTORS ~~~gl:~FR(~-~® SCOTT L. HARRIS, Supervisor Thomas Fisher t ~ « ~'rr ~ Southold Town Hall Building Inspector ~ e~ ~;t ~ P.O. Box 1179, 53095 Main Road Gary Fish ~~d ~'a.~ So Fax (5 6) 765-1g2g971 Building Inspector Telephone (516) 765-1800 Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE : 7~ Building Permit No. ( 7 Owner: i/CC)~a'.c.~ (please print) (please print I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. ( ers Signature) Sworn to before me this . ! day of , 19~. Notary Public, ~Q"`o/~ County ~(~1 ' Notary P blic LINDA J. COOPER Notary Public, State of New York No. 4822563, Suffolk County Term Expires Deoeenber 31,19 INSPECTORS Victor Lessard ' ,r, Principal Building Inspector ~ _ Curtis Horton hY r~ `~%`t~ SCOTT L. HARRIS, Supervisor Senior Building Inspector ~ o vi - Southold Town Hall Thomas Fiaher ~l :y- ; P,O. Box 1179, 53095 Main Road Building Inspector ~,ti ~ " Gar Fish ' . ~ Southold, New York 11971 Building Inspector ?f ~ Fax (516)765-1823 Vincent R. Wieczorek Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD MARCH 26, 1993 RORY & ,lENNIE FORRESTAL 1065 SALTAZRE WAY MATTITUCR, NY 11952 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xxx The check is not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. RIL4 No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 19987-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. r'1cLD li:S: PCTlUi! ~~UA:E I i;OMMEN2° c'o s, H ~ FOUtlDATION S1st) - - ~ c FOUNDATIOtJ ( 2nd ) - - ~ su 2. ~ - z „ o p P,OUGH FRAME & ~ 5' v, PLUMBING . ~f' m m IlJSULATIOt•! PER N. Y. .-3 STATE ENERGY CODE . x a FIiJAL . I ADDITIOPlAL COMMENTS: m x~ r y~4 v/ ' x .b H 7! _ H'J H O `p z ~ x ra b • _ ~ b~ m ro H _ ~r, PETER T. PODLAS, A.I.A. Architect LAILA LANE P O. BO% 265 REM6ENBURG, NV 11960 f.. a. p. (518)326-0929 r~` October 8, 1991 ~y~;/~"_ L~; ~i~~ . ~ . Mr. Gary Fish " `'''~j Southold Building Department Re; 199872, Rory Forrestal, Saltiar Way Dear Mr, Fish, Due to the fact *hat the roof rafters are of a small length on Mr. Forrestals additions I feel that the overhang soffits vehts will he adequate ventilation for the cathedral ceiling. If have you have any further questions feel free to call me. Best regards, ter Podlas /06S' ~'~JZ i .?ice, c~,~ I~~-,r, ; v ~rC ~ N ~ «4~"z.~ ~/o? y~ fly ~ . ~'p v i ifo u~ ~o~,J ,6~06.7e~ I?'lYl-,N ~.o~ So~%?~occ7~ N~ 7/9~f~ i=ce ~ a,- Sx ~o,~s. i r THE NEW YORK BOARD OF FIRE UNDERWRITERS 'PAG:: z' 036E BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date MAY 06,1997. ApplicotionNo.onfile '75036491/91 N 23A178' THIS CERTIFIES THAT only the electrical equipment as described bebEO and introduced by the applicant named on the above application number in the premises of RORY FORRESTAL, 1065 SALTAIRE ~tiAY, MATTITUCK, N, Y. in the foliotcinR location; ? Ba»ement © lot Ff. ? 2nd h'!. Section Block Lot u~as examined on APRIL 29, i992 ondfound to be in cunrplianre with the requirement•R q/'this Board. RXTURE ~ FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ECEPTACIES SWITCHES INCANDESCFNi FIUCRESCENi OTHER AMT. K W. AMi. N. W. ANi K W. AMi. K W AMT. H. P. i~~i,r-!1 3~ g~ 5 1 1 1.2 2 F. DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAL REC'Pi i1ME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS AMi.,, K. W. Oll H. P. GAS H. P. AMT. NO. A. W. G AMT. AMP. AMT. AMPS TRANS. AMT. H P NO. OF FEET AMi. .WAttS 1.. , . t. ~ ~ ' ~ ~ . ~ 2 600 . -SERVICE DISCONNECT NO.OF L, t~-^-u,: ~-~q-,-S. E R V i .C - E 'tc -r=3.~•:' i ;-'ul: AMT. AMP. TYPE METER l.a'IW I,e'aW 3%0W ~A'{W NOAF CC COND. A.W.G. NO.OF HI-LEG A. W. G~~~ NO.OF NFUTRALS A.W.G. EQUIP. PER d OF CC. COND Of HbLEG Of NEVTRAI OTHER APPARATUS: G.F.C,I:-2 6L'12N11Rt) R. GiIT'TINGER LIC.A169-@; 62 ?n^LLCREST AVE E. NORTI?PORT NY, 1.1731 GENERAL MANAGER Per y This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. - _ ~ l 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ( FINAL REMARKS: r DATE ~ ~ 3 INSPECTOR ~ i 1 765-1802 BUILDING DEPT. i INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND ~SULATION [ ]FRAMING t ]FINAL REMARKS: C`~~` c,~-P,~ . F DATE f D INSPECTOR i 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ j ROUGH LBG. ]FOUNDATION 2ND [ NSULATION [ ]FRAMING (]FINAL REMARKS: ~ DATE INSPECTOR /i'd"V t a ~ _ P' 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 15T [ ] ROUGH PLBG. FO ATION 2ND [ ]INSULATION [ FRAMING ()FINAL REMARKS: u~ DATE ~ INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ]INSULATION [)FRAMING [ ]FINAL REMARKS: .,c,~,,.~e.~_~ DATE ` Q~ INSPECTOR ` . } l~l m r. ~ ~ 9 ~ ~ ~ ~ ~ ~ ~y ~I z ~ / ~ ~x O~ m J ~ ~ ui ~ o ~3429~"~_ _ W w u_ ~ ~ ¢ a y ~ m w ~ "n ,l > ~ ~ ,V ~ ~ ~ ~n Z~ ~ ~ o J U n~ ,W o Q z Z5 7 2 q ,y~ v - ^ 5ry h o 2 . ~ ~ , V g F,PvM~d 3 I" of ~(o ~ 1 ~ OwEGU~vG' I ~ p~ "J w ~2 ' W~! , o t1i51 G~oa~;; a ~U SCI Q ~ W h v z m O N =0 4 zO ~ O ~ ' Q ~ ~ h O ~n O~o~We=pj W f~ .ri w ~ ~ ~ N ~ ~ Z O O O~ O O O / ' .y lE- a M°N~ - v ~ ~ ~ ~ J ~ 0 ~ ~ ~ ~ ~C. W o~p ~ Q ~ ~ ~Q Q ~~o I~ U ~ ~ N J ~ ~ V ~ ~l~ o a ~ Q g ~ o ~~,1 { a ~ °Oz~~am J o o F~ Y BOARD OF HEALTH . - . • , , nn~/7 ? FORMNO.1 3 SETS OF PLANS IJ \J ~~`7~ TOWN OF SOUTHOLD . . . It, SURVEY ~ ~ ~+~ry~ i~ BUILDING DEPARTMENT CHECI: • • • • • ~ • _ ~ZVl~ifi TOWN HALL SEPTIC FDrtrt f SOUTHOLD, N.Y. 11977 ~.°~'""'.`~"°"°°~i=- ~ TEL.: 765-1802 r:oTIPY; F3LDr. t~ra~~. TOWN OF SOUTH01_[7 ! CALL /.~f. ...---.......-.~......~..,.,,..,...,e _ . 5~ . Examined 19 rin I L TO Approved . `+.!t'.".~'!~,. a.~.. , 19q~ .Permit No. ~ . 4 g ./..Z- . . DisapprovedaJ/c (Buil e nspector) APPLICATION FOR BUILDING PERMIIT ~j Date Ji?'~, ~:6......, 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. i c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ignatu~e of a~li5ant, or name, if a corporation) Odd r i oziz~,f „rC_ ....f.0 6.S-.S~4e'.rr:rrz . w."?:"/..C'? s?-? 5;.7Jclf,u~!fG (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. c _ Name of owner of premises .~!l.~~..~ ..~e~r?i`!<~:.. !~sc!?p,J.~.'? :Z- . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. ~Q~.. S~?~-:i; 5`~!{_. , .cF?!~,, , , , , , , , , , , , , /065 .....................5'?:L!t,!L~..W~............... ~~~.i: i.iJt~~C.'............ House Number Street Hamlet County Tax Map No. 1000 Section I a:D: !~.4...... Block . O. ! ~ Lot . G'2...3. p~.tJ Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....t~.COJ 17,, e7...~?ld.a??t_'O............ . `~~'',''`':;-4-.r.=.f~aca........ . §.3 b. Intended use and occupancy ........S~n~~ ~ ' : , ,„,,,fi.Y ~'k 3. A'ature of work (check which applicable): New Building Addition 1/... Alteration".,~"~.,;:.:, . Repair . Removal Demolition Other Work ;'i ' a^: . Dye~s~cription) 4. Estimated Cost ....V~.D, Fee . (to be paid on filing this application) 5 If darallennumba of cars elling wits .....il/~/1.. , , , . , Number of dwelling units on each floor .....N~~A . , , , , , , g g , ~l/>L . 6. If business, commercial or mixed'ioccupancy, specify nature and extent of each type of use ....M,/~....... , . 7 Hei~htsions of existing struNumti if any: Front , , , , , .Rear . , Depth . . g erofStories....»~ Dimensions of same structure wit alterations or additions: Front ....(Q ~ , Rear ....6.7.......... . et '7i p ~ .....Numb. Height Number of Stories . $ HemhYsions of entire new construction: Front .~¢e : Sz:Qo.u,I , , Rear ...............Depth . g erofStories ..............................p......................... 9. Size of lot: Front . Qd.......: Rear;....C4.4 De th a~O.~................. . • . • • • .Name of Former Owner ~~:.?.'?'^s~/•9:R~~a!c.:...... . 12. Does ro osed construction viola ises are situated . . . . . . . . 11. one P r up e distnct in which rerjie any zoning law, ordinance or regulation: ...NQ............., , , , , , , , , , , , , 13. Will lot be regraded .....NO.. , , , , , , , , , , ,Will excess fill be removed from premises: Yes No 14. Name of Owner of premisesl~. /.x7.;4rf~q(.. , , .Address /A6S"S!?<-Trg<2 au/!~ .Phone No.M~T,,~~c . . Name of Architect ................Address ...................Phone No............... . If es, Southold T • Address Phone No................ 15. Ismthi* prope>°ty within 3P0 feet of a tidal wetland? *Yes........ No...r~.. y qwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. I ~ d7~ 8 j EaS'.~ 23 a I i b II STATE OF N R COUNTY OFE~.~-Pi(`../I':}. S;S r • ~ • • • • • • • • • ~ • . • being duly sworn, deposes and says that he is the applicant (Name of individual si nin g contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ';authorized to perform or have performed the said work and to make and file this application; that all statements contair?ed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .a~, ~ ~ ,~1aY of . ' . u. 19~~ Notary Public ~ . C-~~.~..... County Notery Publ ~N 48 96 6New~~ QuaUffed In $uffolkCauMy c~ (Signature of applicant) Commlaelon Expires December 8,18L~~